What to Expect When Undergoing a Thyroid Peroxidase Antibody Test (2024)

Thyroid peroxidase (TPO) is an enzyme made by your thyroid, the butterfly-shaped gland located in the front of your neck. The thyroid gland uses TPO along with iodine to generate the thyroid hormones triiodothyronine (T3) and thyroxine (T4). Together, these hormones regulate body temperature, heart rate, and metabolism. They also promote growth, development, and maturation of the brain and nervous system.

Antibodies serve a purpose in your body; they defend against bacteria, viruses, and toxins. In an individual with a healthy functioning immune system, the body views TPO as an essential, hormone-making enzyme. However, in individuals with an autoimmune condition, the body can form proteins called antibodies, which attack healthy tissues and organs, including the thyroid.

What to Expect When Undergoing a Thyroid Peroxidase Antibody Test (1)

If you have an autoimmune thyroid disorder, your blood levels of TPO antibodies can increase and can be detected with a simple blood test. Further testing may be needed to determine the cause and offer a diagnosis.


The TPO antibody test is done to help diagnose Hashimoto’s thyroiditis. The symptoms that may be indicative of Hashimoto’s thyroiditis include:

  • Fatigue
  • Menstrual irregularities
  • Dry skin
  • Brittle nails
  • Constipation
  • Cold intolerance
  • Muscles aches and pains
  • Depression
  • Brain fog

Additionally, your healthcare provider might order other thyroid tests in conjunction with the TPO antibody test, which could include thyroglobulin antibodies, thyroid-stimulating hormone (TSH), free T4 hormone, and T3 hormone.

Risks and Contraindications

The TPO antibody test is considered safe, and the risks associated with it are mild. If you’ve had a previous blood sample taken from your arm, this test will be similar. Veins differ from person to person. In some cases, your nurse or technician may have trouble finding a vein and may need to insert the needle more than once to collect blood. This may cause slight pain.

Also, you might experience bruising or a stinging sensation at the insertion of the needle—bruising may be alleviated or minimized by keeping a bandage in place for the amount of time the clinician recommends following the blood draw. The discomfort should disappear in a day or two. On a rare occasion, a vein may swell and cause a condition known as phlebitis, which is often treated using warm compresses throughout the day.

Sometimes, people may feel faint or lightheaded with blood tests. If this describes you, be sure to let the technician know so that you can remain seated in the chair for a couple of minutes before getting up. You may also have the option of taking the test in a lying position.

Before the Test

Since the TPO antibody test may be done with other thyroid tests, your healthcare provider may ask you to stop taking medications that could affect your thyroid levels. These may include thyroid replacement drugs, steroids, certain heart medications, and others.

Be sure to notify your healthcare provider about any medications, herbs, and supplements (including over-the-counter ones) that you are taking.

Your healthcare provider will provide you with specific instructions for taking this blood test. You could be asked to avoid eating and drinking for several hours before having your blood drawn; often, this is most conveniently done overnight before the test.

On the day of the test, you’ll be able to wear your normal clothes. But to make it easier for the technician to access your veins, you may want to consider wearing a shirt with sleeves you can roll up. Also, be sure to bring your insurance card and a form of identification with you so that the healthcare facility can bill your insurance carrier.

Remember that reimbursem*nt for testing varies among insurance companies, so you may need to speak to your carrier to determine if you need pre-approval when doing a TPO antibody test.

During the Test

Typically, a lab technician will ask you to sit in a chair while one arm rests in front of you. Then, the lab technician will place an elastic band around this arm to restrict blood flow for a short time to locate a vein. After that, they will disinfect the area with an alcohol swab or pad.

Once the area has been disinfected, they’ll insert the needle into your arm and they’ll attach a tube that collects the blood at the base of the syringe. When enough blood has been drawn for the test, the lab technician will remove the elastic band, take out the needle, and place a bandage over the location of the puncture. Usually, this type of blood test only takes a few minutes.

After the Test

Following the test, your healthcare provider will provide you with any particular follow-up instructions when necessary. For example, if you had to fast before the test or skip medications, your healthcare provider will let you know if it’s okay to resume eating and taking your prescriptions.

Unless otherwise advised, you should be to go back to your normal activities. Generally, you’ll have the results of the tests in a couple of days.

Interpreting the Results

When there are no antibodies found in your blood, this is considered a negative and normal test result. If your test is positive, meaning antibodies were present in your blood, this could indicate that there is an autoimmune condition affecting your thyroid gland. If the test is negative, it is less likely that you have Hashimoto's disease.

On its own, a TPO antibody test has limited diagnostic value. This is because 8% of men and 14.6% of women will test positive for TPO antibodies even if they have normally functioning thyroid glands.

It is only when the TPO antibodies are compared to other thyroid tests, most especially TSH, that a healthcare provider can make a more definitive diagnosis. Even so, if the disease is subclinical (with no overt symptoms) or the TSH is borderline normal, some experts discourage TPO antibody testing. Doing so may lead you to believe that you have autoimmune thyroid disease when you don't and divert you from the real cause of your symptoms.

Most likely, your healthcare provider will view your testsas one part of a larger picture, which includes other thyroid lab results, your symptoms, and your medical history.

A Word From Verywell

If you receive a positive test result from a TPO antibody test, your first reaction might be to feel a bit nervous. But remember, there are several reasons you may have a positive test, and you have many treatment options available to you. To put yourself at ease, make sure you have a healthcare provider whom you trust. A trusted provider can answer any questions and concerns so that together, both of you can make the best decision for your health.

Frequently Asked Questions

  • Why are thyroid peroxidase antibodies tested?

    Thyroid peroxidase (TPO) antibodies are tested to help diagnose Hashimoto's disease. This is an autoimmune disease that attacks the thyroid gland and affects its function, leading to hypothyroidism.

  • What do thyroid peroxidase antibodies do?

    In people with an autoimmune thyroid condition, thyroid peroxidase antibodies mistakenly attack a key enzyme involved in producing thyroid hormones. This leads to low levels of thyroid hormones and hypothyroidism.

  • What happens during a TPO test?

    TPO antibody tests are performed in a doctor's office or laboratory and requrie a blood sample. The healthcare provider will place an elastic band around one arm to restrict blood flow and locate a vein. After disinfecting the area using an alcohol swab, they use a needle to draw blood from the arm. After enough blood has been taken for testing, the elastic band is removed and the needle is pulled out.

What Factors Affect Your Thyroid Test?

What to Expect When Undergoing a Thyroid Peroxidase Antibody Test (2024)


How long does it take to get the results of a TPO antibody test? ›

Anti TPO test details in brief.
Also known asAnti TPO Antibodies test, Thyroid peroxidase antibody test, TPO antibody test, Antithyroid antibodies test, AMA Test
PreparationAvoid multivitamins or dietary supplements containing biotin (vitamin B7).
Fasting requiredNo fasting is required.
Reporting time8 to 24 hours
2 more rows

What does a thyroid peroxidase antibody test tell you? ›

The presence of TPO antibodies in your blood suggests that the cause of thyroid disease is an autoimmune disorder, such as Hashimoto's disease or Graves' disease.

How do you prepare for a thyroid antibody test? ›

There are no special preparations necessary for a thyroid antibodies blood test.

Do I need to fast for thyroid peroxidase test? ›

No special preparation is required for a thyroid antibodies blood test. If you have thyroid function tests such as TSH, T3, or T4 at the same time as the antibodies test, be sure to tell your doctor about any medications or supplements you are taking.

What TPO level indicates Hashimoto's disease? ›

The majority of normal subjects had anti-TPO levels below 52 U/ml and patients with Hashimoto's thyroiditis had levels above 200 U/ml, with a good correlation to MicAb. In other autoimmune thyroid diseases the correlation was less pronounced.

What test confirms Hashimoto's disease? ›

Antibody tests

To determine if Hashimoto's disease is the cause of hypothyroidism, your health care provider will order an antibody test. The intended purpose of an antibody is to flag disease-causing foreign agents that need to be destroyed by other actors in the immune system.

What does a Hashimoto's flare up feel like? ›

Symptoms of a Hashimoto's Flare-Up

Fatigue. Cold intolerance. Constipation. Dry skin.

Should I worry about thyroid antibodies? ›

Thyroid antibodies often remain in the body even after the thyroid disorder has been successfully treated. The presence of antibodies in a person with subclinical (or borderline) thyroid disease can indicate a person may go on to develop full-blown thyroid disease in the future.

Do TPO antibodies always mean Hashimoto's? ›

Thyroid Peroxidase Antibodies

Having only the TPO antibodies present with normal TSH and free T4 levels means that your thyroid is functioning normally and you don't have hypothyroidism, but it does mean that you may have Hashimoto's disease. Remember that Hashimoto's doesn't always cause hypothyroidism.

What not to do before a thyroid blood test? ›

The thyroid “takes up” iodine from the blood to make thyroid hormones, which is why this is called an uptake test. Your health care professional may ask you to avoid foods high in iodine, such as kelp, or medicines containing iodine for a week before the test.

What is the best time of day to have a thyroid test? ›

Having balanced thyroid levels is really important, and taking your thyroid test at the best time of day to get the most accurate results is also super important. Taking your test in the morning is the most advisable time of day to ensure maximum accuracy.

What can affect thyroid test results? ›

What can affect thyroid test results?
  • Certain medications and supplements.
  • The time between the last time you took your thyroid medication and when a provider draws your blood. ...
  • Whether you ate before your test (only a factor with thyroid scans).
  • Stress, including the effects on a non-thyroidal illness.
May 30, 2023

Can I drink water before thyroid test? ›

It is a simple blood test that requires no fasting, which means you can eat or drink normally before the test. Can we take Thyroid Tests during Pregnancy? Yes, if your doctor has suggested a thyroid test, you can take it.

Does caffeine affect thyroid blood test? ›

Scientific studies that assessed the effects of caffeine consumption on TSH (a hormone that affects thyroid function) concentrations, observed reduced TSH concentrations as a result of consuming an amount of caffeine equivalent to three cups of coffee.

What is a good thyroid peroxidase number? ›

Normal TPO antibodies range is less than 34 international units per millimetre (IU/ml). Thyroid peroxidase antibodies are considered high if above this.

How long does a thyroid antibody blood test take? ›

2-3 days. May take longer based on weather, holiday, or lab delays.

How long does it take for antibody test to work? ›

After infection with the COVID-19 virus or a COVID-19 vaccine, your body can take 2 to 3 weeks to make enough antibodies to be found in an antibody test. So it's important that you're not tested too soon. Antibodies may be remain in your blood for many months.

How long should you wait for antibody test? ›

Current research shows that it may be best to get antibody testing 3 to 4 weeks after symptom onset or known exposure to COVID-19 to lower the chance of receiving a false positive or false negative result. Talk to your healthcare provider for more information.

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